两种选择素基因多态性对冠心病风险的异质性影响：荟萃分析。
Heterogeneous effect of two selectin gene polymorphisms on coronary artery disease risk: a meta-analysis.
机构信息
Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
出版信息
PLoS One. 2014 Feb 3;9(2):e88152. doi: 10.1371/journal.pone.0088152. eCollection 2014.
BACKGROUND
The selectins play important roles in the inflammatory process of coronary artery disease (CAD) and myocardial infarction (MI). Previous studies have shown ambiguous findings regarding a possible association between the selectin genes and CAD. The E-selectin Ser128Arg polymorphism and the P-selectin Thr715Pro polymorphism have been investigated widely but with inconsistent results. We performed a comprehensive meta-analysis to shed light on this issue.
METHODS
Data were extracted by searches of MEDLINE, Embase, CNKI, Wanfang, Google Scholar, PORTA, GeNii, CiNii, J-STAGE, Nurimedia and Koreanstudies Information Service System [Kiss] up to October 2013, in which 10 studies on the Ser128Arg polymorphism with 3369 cases and 2577 controls and 10 studies on the Thr715Pro polymorphism with 5886 cases and 18345 controls. A random-effects model was used to calculate the combined odds ratios. The between-study heterogeneity and publication bias were addressed.
RESULTS
The 128Arg carriers had a significant increased risk of CAD (allele comparison: P = 0.02, OR = 1.33, 95%CI 1.04-1.69, P(heterogeneity) = 0.01); The 715Pro conferred a non-significant risk reduction relative to the 715Thr (allele comparison: P = 0.40, OR = 0.94, 95%CI 0.82-1.08, P(heterogeneity) = 0.03).Subgroup analyses demonstrated that the 128Arg carriers had a significant increased risk of CAD among Asians (allele comparison: P = 0.001, OR = 2.07, 95%CI 1.33-3.24, P(heterogeneity) = 0.77) but not among Caucasians (allele comparison: P = 0.33, OR = 1.13, 95%CI 0.88-1.45, P(heterogeneity) = 0.08). Carrier status for the 715Pro was significantly associated with reduced risk of MI (allele comparison: P = 0.04, OR = 0.81, 95%CI 0.67-0.99, P(heterogeneity )= 0.14). The asymmetric funnel plot and the Egger's test (P = 0.041) suggested the presence of publication bias for the Ser128Arg polymorphism.
CONCLUSION
Our results suggested there is an increase in the risk of CAD conferred by the Ser128Arg polymorphism and the thr715Pro polymorphism may be a protective factor of MI.
背景
选择素在冠状动脉疾病（CAD）和心肌梗死（MI）的炎症过程中发挥重要作用。先前的研究表明，选择素基因与 CAD 之间可能存在关联的结果并不明确。E-选择素 Ser128Arg 多态性和 P-选择素 Thr715Pro 多态性已被广泛研究，但结果不一致。我们进行了一项综合荟萃分析，以期阐明这个问题。
方法
检索 MEDLINE、Embase、CNKI、Wanfang、Google Scholar、PORTA、GeNii、CiNii、J-STAGE、Nurimedia 和韩国研究信息服务系统 [Kiss] ，截至 2013 年 10 月，纳入了 10 项有关 Ser128Arg 多态性的研究，共 3369 例病例和 2577 例对照，以及 10 项有关 Thr715Pro 多态性的研究，共 5886 例病例和 18345 例对照。采用随机效应模型计算合并的比值比。评估了研究间异质性和发表偏倚。
结果
128Arg 携带者患 CAD 的风险显著增加（等位基因比较：P=0.02，OR=1.33，95%CI 1.04-1.69，P（异质性）=0.01）；715Pro 与 715Thr 相比，风险降低但无统计学意义（等位基因比较：P=0.40，OR=0.94，95%CI 0.82-1.08，P（异质性）=0.03）。亚组分析表明，亚洲人群中 128Arg 携带者患 CAD 的风险显著增加（等位基因比较：P=0.001，OR=2.07，95%CI 1.33-3.24，P（异质性）=0.77），而白种人无此相关性（等位基因比较：P=0.33，OR=1.13，95%CI 0.88-1.45，P（异质性）=0.08）。715Pro 携带者患 MI 的风险显著降低（等位基因比较：P=0.04，OR=0.81，95%CI 0.67-0.99，P（异质性）=0.14）。不对称漏斗图和 Egger 检验（P=0.041）提示 Ser128Arg 多态性存在发表偏倚。
结论
我们的研究结果表明，Ser128Arg 多态性与 CAD 风险增加有关，而 Thr715Pro 多态性可能是 MI 的保护因素。
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